Hi Guys,
Just wanted to post a decent (and recent 2019) article I found about the stability of just about all the types of orthognathic surgery you could have.
https://www.institutomaxilofacial.com/wp-content/uploads/2019/04/Hierarchy-of-surgical-stability-in-orthognathic-surgery-overview-of-systematic-reviews..pdfThey have gone through thousands of studies narrowing it down to about 150 that discuss surgical stability with different techniques. Ultimately by analysing these articles they have created a hierarchy of procedures and technical approaches that are the most stable. Of these 150 studies over 6000 patients were evaluated.
An interesting thing I will note about this is you can compare the same procedure and see which fixation method can improve stability. E.g." BSSO CW rotation with bicortel screw RIF + plate" is far more stable than the same procedure only with bicortel screws and no plates. With plates being highly stable whilst without is extremely unstable, 2nd lowest in the hierachy.
It seems that just about all movements can be done with "highly stable" or "stable" results according to the study if the appropriate approach is followed.
Issues with this study I would like to highlight:1) Huge variability in key data points such as the follow up time (between 1-15 years, mostly only 1-3 years for most studies).
2) Some clarity but ultimately not enough specification about which study involved which dentofacial deformity and the precise method/surgical technique that was performed to correct said deformity and how this translates into the final stability assessment.
3) For less common methods or dentofacial deformities, there is no clear assessment of stability because the sample size is too small.
Overall however it is one of the best articles I have seen about this topic.
Thanks and God bless,
